Surveillance épidémiologique de la coqueluche dans les armées françaises en 2007

Objectives

Pertussis surveillance in the French general population was stopped in 1986. Pertussis was added to the list of illnesses surveyed by the military epidemiological surveillance network ecause of outbreaks having occurred among French servicepersons and in military high schools. This study had for aim to report the results of the first year of surveillance.

Design

Pertussis declaration criteria were those recommended in 2006 by the French council for public hygiene. The data concerning active military servicepersons was collected by physicians of all military medical units. An anonymous declaration form was used for data collection.

Results

In 2007, 66 cases of pertussis were reported in the military forces, 10 of which were excluded after a negative biological test. The classification of the 56 included cases was: 46% biologically confirmed cases, 20% clinically confirmed cases, 14% suspected cases, and 6% epidemiologically confirmed cases. The incidence density rate was 16.3 cases for 100,000 servicepersons-years. Age under 20 was associated with a 4.6 fold higher risk to develop pertussis.

Conclusions

The high incidence rate observed in individuals under 20 years of age could reflect a shift of pertussis reservoir to young adults, as observed in industrialized countries after generalization of vaccination programs. However, several years of surveillance will be needed to confirm this hypothesis. Meanwhile, the military epidemiological network could constitute an important surveillance marker of pertussis among adults in France.     

Effets d’âge et de génération : transformation du modèle alimentaire

The traditional food model of French resting on user-friendliness, food diversity, the regularity of the schedules of the meals… is less and less followed by the younger generations. By these generational changes, one attends not with a disappearance of the French food model or with a destructuration of the meals but a modification of this model: reduction in the number of dishes and the make-ready times, irregularity of the schedules of meal, increase in the tray meals and rise of products the processed and flat exotics with the detriment of the basic commodities. This evolution answers the modifications of the ways of life which require saving of time, praticity and convenience. This basic trend is accompanied by a concern growing with respect to the health which gains all the generations and results in a strong growth of the market segments of the food health. The third dimension of the food triptych is the basic base of the French food which perdure in new forms: pleasure in the food. It results in the development of the invitations at home in the form of aperitifs dînatoires and of the kitchen leisures which takes form through the courses of kitchen.     

Étude de la résistance des souches d’Escherichia coli isolées dans les urines aux fluoroquinolones et aux céphalosporines de troisième génération

Objectives

This study had for objective to assess the frequency of resistance to fluoroquinolones and to third generation cephalosporin in E. coli isolated from urines of consulting and hospitalized patients and to detect the rate of multiresistant E. coli strains.

Design

A retrospective survey was made over 3 years (1^st January 2005 to 31^st December 2007). Eight hundred and nineteen patients presented with UTI confirmed in the Rabat Cheikh Zayd Teaching Hospital.

Results

E. coli was the etiologic agent in 57% of reported UTI. The frequency of E. coli resistance to fluoroquinolones was 27% with a higher rate among hospitalized patients. We found that ten E. coli strains were producing extended-spectrum β-lactamase and resistant to aminosides and fluoroquinolones.

Conclusions

The resistance of E. coli to fluoroquinolones is becoming worrying among consulting and hospitalized patients. Ten strains multiresistant to fluoroquinolones and third generation cephalosporins, probably because of plasmids, were isolated. This increasingly frequent resistance mechanism should lead to a more careful use of first line fluoroquinolones for UTI.